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. ..__ _ __ _. . _ .1 <br /> ; ELE�TRICAL PERMIT APPLICATION <br /> �ITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> ' 425-257-8810 - FAX 425-257-8857 -wv�nv.everetlwa.org ; <br /> 2�25 (',D�. •�`-l1�'U� `Uti�i� �,t�,� � �6oU-�ocf <br /> � � _ , ,,ti 9 y-9-a5 i <br /> , <br /> PROJECT AODRESS i <br /> Owner fAan A:dress Gty SlateRip Phone <br /> dZ�-�S�1i'- <br /> v tJ l0� PJ��- 2� � l C�P-b`9 �v� GVG"Q,C-;i r' ��-v� CtcYLa�+ O'i�')- I <br /> I Tenant Idail Address Uty State/Lp Phone <br /> I <br /> j lD IS c,r,.r�n�t� -�- �S 1�=-Nt" vv,� �Yo3Z �t2►-�tK�-6.R��7 <br /> Glednca�Contractor tlailAddmss C��;y 5ta'elLp Phone <br /> � �Lt,�G�a�2� SY�('� oL'� s-Cg _ � <br /> State L�cense Number(required) City of Everelt Business L�cense Number (required) <br /> `�"L�-�� <br /> � Proposed Use of Eudding Contract Price of Work <br /> � 4a_{_ �i a'a�r U��!!�7 <br /> ! Square Footage Qf resident�al new construdioq remodel or addilion) Contad Persoti'Contad Number/Ema�l <br /> � <br /> Number of devices pf low voltage) <br /> I Descnplion ol Wotk lo Be Done: f�{�� �- L'.4�-�4�- � �l STL�`� �, v ''�'�n �' M�–�L <br /> a� L�P���Y ---- <br /> FEE -- <br /> CITY OF EVERETT LOCQL SALES TAX CODE IS J105 1�1 { 1."�` �i <br /> `Y1 { J <br /> I1 hcreby certily lhat 1 have mad and examined fhis apphcation and know lhe same fo be Irue and —_ __ <br /> conrd Afl provisrons o/la�vs and ordinances goveming fhis type ol work wdl be comp/eted <br /> Ir�hefher specdied herein ornot The granling ol a pemiif does nof presume to give aufhonfy fo PERh11Th <br /> violatecrcancelllreprowsionsolanyothersfateorlocalla�vregulatingwnsfrdc(ionortfre � i�o � ��� <br /> perfomaance ol construcfion That i am authonzed by Ihe owner ol fhis property to perfonn ffie <br /> �vcr�lor which applicafron rs made nd I cumply wifh the Stafe Conlracfors La�v 18.27 RCW and <br /> 296 200 WAC I <br /> �� /�"�'4 � 4 � I <br /> ; Signatore ' Da!e <br /> HEVISEG CS^.:+r <br />